Sean P Mackenzie, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

036-111320 Issued in IL

Practice address

324 Roxbury Rd
Rockford, IL 61107-5090

Phone

(815) 398-9491

Fax

(815) 381-7498

NPI assigned

Aug 20, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physical Medicine and Rehabilitation

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Divine Savior Healthcare IncGroup PAC ID 5799684007, 135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aspirus Divine Savior Hospital Hospital, Portage, WI, CCN 520041

Merit-based Incentive Payment System (MIPS)

Final score

91.7 of 100Reported as group

Quality

91.14

Promoting interoperability

100

Improvement activities

40

Cost

77.5

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smackenzie126548@direct.aspirus.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Divine Savior Healthcare, Inc.

  • General Acute Care Hospital
  • Portage, WI
  • NPI 1124083894
  Medicare reassignment Care Compare group NPD
• Aspirus Medical Group, Inc.

  • Clinic/Center
  • Wausau, WI
  • NPI 1003021452
  Medicare reassignment
• Aspirus Medical Group, Inc.

  • Clinic/Center
  • Wausau, WI
  • NPI 1669595294
  NPD
• Aspirus Medical Group, Inc.

  • Obstetrics & Gynecology Physician
  • Wausau, WI
  • NPI 1942084199
  NPD
• Divine Savior Healthcare, Inc.

  • Rural Health Clinic/Center
  • Portage, WI
  • NPI 1386154417
  NPD
• Southeast Texas Hematology and Oncology Center, PA

  • Specialist
  • Port Arthur, TX
  • NPI 1598749491
  NPD (past)
• Triangle Therapeutics

  • Specialist
  • Port Arthur, TX
  • NPI 1619995651
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Divine Savior Healthcare, Inc.

  • General Acute Care Hospital
  • Portage, WI
  • NPI 1124083894
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1063527349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 78534",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53278",
            "telephone_number": "815-398-9491",
            "fax_number": "815-381-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075090",
            "telephone_number": "815-398-9491",
            "fax_number": "815-381-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "SEAN",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036-111320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-111320",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sierra Maaske, APRN
• Nicole Oluwabunmi Macaulay, M.D
• Machesney Bay Dialysis, LLC
• Melissa Yvonne Macias, MD, PHD
• Amanda Macke, APN
• Debra Mackey, RN
• Amanda Macquoid, MD
• Catherine J Maculan, DACBSP
• Samragnyi Madala, MD
• Kashyap Maddali, DDS

• Physical Medicine & Rehabilitation Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.